Inflammation lies at the bottom of chronic disease - diabetes, high blood pressure, arthritis, some forms of depression and anxiety, heart disease, stroke, COPD (chronic bronchitis), osteoporosis, certain cancers, chronic pain, autoimmune diseases, Alzheimer’s and other dementias, allergies, asthma, eczema and other skin diseases, heartburn, gastritis – and so many more. Yes, often you would not get these diseases if you didn’t have the right (or wrong) genes. But let’s face it: Most of us carry the genes for those diseases. All we need is a bad lifestyle to trigger chronic ailments. All of which make your life miserable.

Of course, the main reason for the development of chronic diseases is that we are reaching older age than we used to – we have more time to hatch illness. But it is not that old age automatically renders you invalid and decrepit. One can have a healthy old age! But it takes some luck, and some effort.

So what are the habits that trigger chronic inflammation and chronic diseases? The usual – and well-known - culprits: Inappropriate diet, too little movement (or too much!), environmental pollution of water, air and soil, psychological stress, unhappy relationships, unfulfilling jobs, drugs (medical and recreational), deficient water intake, unnecessary drugs, overweight and obesity, vitamin D deficiency, unnecessary antibiotics that kill the natural microbiome in our guts and on our skin. Another list that could go on and on.

How do you tell that inflammation is damaging your body? Well, if you already have a chronic disease - that is the proof of the pudding. But If you are at the stage before a doctor runs some tests and finally makes the diagnosis – if you are in the pre-stages of disease – you might inspect your fingers for the telltale signs of inflammation: a red halo around the root of the nail, at the area of the nail bed.

That halo can be thin and faint, and it can be thick and swollen. In some patients, the redness goes up half their digits, or higher. It is an early sign of inflammation, and one doctors usually don’t know about. In fact, I didn’t learn this in medical school – I observed it in my patients.

The beauty of it? If you clean up your act, the halos get smaller and paler – you see within a few days that you are on the way to improvement. Especially if you leave out some offending allergenic food – the most common guilty parties here are dairy, gluten, nuts, sugar.

Why is it that your fingertips can tell me the state of your health, the degree of inflammation? Traditional Chinese Medicine uses the tongue to tell about illness and well-being. My favorite European teacher Sebastian Kneipp used to base his diagnoses and prognoses on the shape and color of the earlobes; he must have come to it by simple observation, just as I did. The tongue, the earlobes, the fingertips – why those? Mainly because they are easily visible. For sure, if your body is riddled with inflammation, you will have signs of it in nearly all your inner organs. But the inner organs are hidden from direct inspection. For evaluating the tongue, I’d have to ask the patient to open her mouth. Earlobes and fingers are there for the looking. – Your fingers and nails can tell the doctor much more about your health (or un-health). But the FFD is easy for lay people.

Let me tell you right away that I don’t yet know if only food allergies can trigger the redness of the fingers, or if other toxins or pathology processes do it too. I would think so. But there has been no study yet, just quiet observation on my patients.

What I like about the Fleckenstein Finger Diagnosis (FFD): It is a do-it-yourself tool. You don’t need me to tell you something is wrong. You just need to look down on your fingertips. And if you see a reddish halo: Get up from your chair, and do something for your health: Go for a walk, and clean out your pantry!

Medicine, for me, is a quest for my healthier self, and healthier patients. I am learning something new every day. In a way, I feel sorry for my patients of so many years ago – now, I think, I could help them so much better.

This also implies that you – the patient – could possibly be a step ahead of your physician, if you are trying to figure out what makes your body feel better and stronger and more awake, and happier. With the Internet, we all have more information at our fingertips, flawed and good information, for sure – but more of the latter. If you ask me.

Take for instance the stomach problems that plagued me when I was younger. Setting out with conventional drugs like H2-receptor blockers (Tagamet, Zantac) and proton-pump inhibitors (Prilosec, Prevacid) years ago, I at least got the problem under control. Then, twenty years the, I found that at the root of my heartburn and stomach aches were allergies: I left out the offending foods – and I dropped all meds, and never looked back.

Forward a bit, and I discovered probiotics – bacteria that are helpful for the intestines. They improved my bowels, and I took them faithfully for many years. I still recommend them to nearly every patient I encounter. Many studies link probiotics to good clinical outcomes, even if we have not yet quite figured out all the intricacies of how they work. One thing is sure: What you eat helps or destroys the microbiome that coexists in your body. A microbiome is the whole entity of bacteria, good or bad, that thrives with you, in you, on you.

Don’t worry – the good guys are winning right now. Otherwise you would be dead. But that the good guys are winning is not guaranteed – it could change any moment. You could crowd out the good guys with sugar, or commercial dairy, or destroy them with a course of antibiotics) or meat from one of those inhumane, antibiotic-resistance breeding feed lots – the list is long how you can hurt your microbiome inside and outside; cosmetics and household cleaners are high on the list. But even if we did everything right in our personal lives, outside forces can destroy your good bacteria – pollutants in water, air and soil.

Not to be an alarmist, but no man is an island, and if we don’t preserve our Mother Earth, we surely can forget about the intricacies of feeding our coworkers - our good bacteria - the right amount of this and that.

Health comes down to the health of our gastrointestinal tract. Lately, I have found that probiotics can be applied not just as capsules or caplets, but as probiotic foods. A big group which I just mention in passing are fermented foods – sauerkraut, miso, kimchi, tempeh, and so on. “Fermented” can be taken as another word for “loaded with gut-healthy bacteria”.

I have argued widely against the dangers of dairy – and still do. Ninety-nine-point nine percent of dairy is bad for you because of the highly inflammatory proteins and cancer-breeding hormones (be it naturally occurring, or gene-technologically inserted). But there is a tiny fraction of organic dairy that contains live cultures. Examples are yogurt, kefir, buttermilk and sour cream. But only, if they truly are organic, contain live cultures and have absolutely no additives that turn a good food into a nightmare: sugars, sweeteners, fruit, fruit substitutes, tapioca, carrageenan, and so on. In my mind, to qualify as natural they also have to have their full fat content – nothing skimmed or improved or processed any way other than pasteurizing – and the good bacteria have to be added afterward. Fat is not the culprit in milk and milk products – milk proteins are. Not only are they inflammatory, but also addictive. Now you can even get dairy-free organic yogurts, made for instance from almond milk. Or probiotic powders, ready to be dissolved in warm water. But always read the labels for ingredients!

Good dairy bacteria do not take away dairy’s inflammatory proteins and cancer-causing hormones. Therefore these probiotics should be taken in small amounts – very small amounts, indeed: a sip or a teaspoon full is the serving size here. And you don’t eat or drink them. You swish them around in your mouth as long as you can stand it, or unless you forget about them, and finally swallow them.

Probiotics thus taken increase not only your gut health, but especially your oral health. Studies show that probiotics swished around in the mouth after brushing your teeth reduce caries and gum disease in most cases – and I bet the result would be even better if people would add a healthy, sugar-free diet on top of this.

Using this to fight caries sure beats taking poisonous fluoride. Fluoride made me always uneasy: Studies link fluoride to cancer and neurotoxicity. But other studies clearly showed that it reduced caries – and I had not yet come by a natural method to preserve my teeth. Granted, “primitive” societies usually boast perfect teeth, but I had not quite found out why. Not sure, why, but sugar-free nutrition was probably the main cause. Then again, who of us modern Americans can boast a totally absolutely sugar-free diet – since infancy? Not that I know anyone.

Still, I am a believer in brushing and flossing (and also with good results, I have to say) – and don’t want to get rid of that. But neither fluoride toothpaste appealed to me, nor the brutal cleaning of my teeth at the dentist’s office twice a year. There is nothing natural in putting sharp metal scraping objects in your mouth. Now I am using an organic, neem-based tooth powder most of the time.

With oral swishing probiotics we gently provide a mildly acidic environment in our mouths for a few minutes. That cleans your teeth of plaque and implants healthy bacteria into the lining of your mouth, which then can grow during the next hours, or overnight, and fight bad bacteria. The result is amazing. And natural.

We take for granted that with advancing age we will lose our teeth, and that diseases will creep up on us. Ever been to a nursing home? A certain old-age odor emanates from those old bodies. We think the odor is normal. It is not. If one eats well, nourishes one’s oral cavity and intestines, in their entire length, and not destroys the precious skin bacteria with harsh soaps and cosmetics, we would smell like babies until our final days (and those will come even if we take good care of ourselves, but I bet those final days with be sweeter and easier if you have lived your life well).

Working on the microbiome in my mouth – that has been the newest station on my medical quest. In a way, this quest has been a journey from mouth to anus - and still is.

If you have a black thumb and all plants wither if you just look at them, you still should have one houseplant, namely aloe. It does not ask for much: Put it on a windowsill and water it once in a while. The danger is more in over-watering, not in under-watering, as it is a desert plant. Its rosettes are boring, and the spiny edges of its leaves might be out to get you.

Aloe vera is a succulent (meaning: storing water) plant that comes from the arid regions of the Arabic peninsula and Northern Africa. It has been cultivated for thousands of years due to its medicinal properties, and one can’t find any natural stand anymore in the wild – all now existent plants seemed to have been planted purposefully – certainly this is a hint that aloe is a useful plant.

Aloe has long leathery leaves. The leaves can be spotted or not, the plant can be smaller or bigger – doesn’t matter. All the aloe one can buy has the medicinal properties.

Why do I want to sing the praise of Aloe vera here?

Last week, concentrating on my calligraphy, admiring the black lines of my brush on the paper, suddenly a beautiful red streak mixed itself in – a truly amazing color scheme: black, white and red. Only, the red was bleeding from one of my knuckles – and I didn’t even know how I had hurt myself. A flap of skin was barely hanging on. I applied a bit of tea tree oil and a band-aid, and continued my calligraphy.

It healed slowly - being on the knuckle where constant movement stretches the skin, didn’t help. Every time I thought I could take off the band-aid, the flap hung onto something, and the wound ripped open again, and bled. Taking onions out of their netting, stacking the stove, retrieving glasses from my pockets – everything conspired that the wound wouldn’t, couldn’t heal.

Then I thought of aloe. I have several plants in the house. I cut off one of the fleshy leaves at the base, and dripped some of its juice onto my knuckle, after I had reapplied tea tree oil. Aloe vera is said to have antiseptic activities too, but tea tree oil is always my choice to prevent infection of wounds. This time I skipped the band-aid. The juice dries to a film, and underneath healing takes place.

Within minutes of applying the aloe juice, the wound looked less angry. After two hours it had shrunk to about half its size. I could better see what was still viable tissue and what not – I cut of the dead protruding ends, and now I am not as likely to rip open the wound again.

Since yesterday, I have applied this mixture of tea tree oil and aloe juice several times. Today the wound is a quarter of what it had been, all redness is gone, and I assume by tomorrow all will be fine.

Because aloe heals wounds so quickly, it should never be applied to a deep wound - say, a bed sore or a surgical cut. Aloe would further superficial healing and wound closure so fast that the underlying wound could still be festering, and then break open again. Aloe is for superficial wounds only!

In the summer, comfrey does a similar spectacular job of healing a wound, but few people even know the plant with its soft felt-like large leaves and lovely purple drooping blossoms, and even less would know how to apply it to a wound (mash the leaves first – or chew them).

One also can buy huge aloe leaves in Chinese supermarkets and health food stores. Those I would first wash with a mild detergent before cutting – who knows how they have been treated before!

Interestingly, scientists are still debating if aloe furthers wound healing. They must have never watch the wound shrink within minutes after applying the plant juice to the wound. I suspect that studies were done with commercial aloe preparation – and those might not work the same way as fresh juice.

Each time I want to use the plant, I cut a thin slice of the leave, just to renew the cut surface, and immediately juice drips out.

Now that I have sacrificed a whole leaf, I will put the rest to good use: I brush my teeth with the inside gel because it heals gums. I also eat the gel when I have an upset stomach. Never eat the outside hard part of the leave as it contains aloin, a strong laxative that has been banned from over-the-counter- preparations because it is harsh on the intestines, and could even lead to the miscarriage of a baby. Whereas the inside gel is soothing and anti-inflammatory. So finishing up the leave, eating a few bites here and there, will do my whole body good. Aloe is also used as a food stuff, so there is no harm in eating it – on the contrary!

When we come back from traveling, our cat’s litter box usually is a mess.

Sorry, I bring up this stinky subject – but it has relevance not only for cats and pets, but also for humans.

Of course, bodily waste products don’t smell like roses. But they also should not smell THAT disgustingly. If they do – in pets and people – chances are something is wrong with the digestive tract.

Now the hardest part is to compare your bowel movements with everybody else’s because we usually are discrete about our defecation results. We don’t know how other people smell or look … in the toilet bowl.

Feces definitely should not reek that it turns one’s stomach. The smell should make you want to flush the toilet – not to run away. And stool should not float, nor should it be excessively sticky, large, or gray-colored.

So, what had happens with our tomcat Otto when we travel? A kind neighbor comes over to feed him. To make it not too complicated for her, we switch to commercial – mostly dry – food. Commercial food contains all kinds of substances unhealthy for a cat, especially wheat and corn products. Predictably, every time our Otto gets extremely stinky on that kind of nutrition.

It takes only a few days and my self-cooked meals that his litter box s ias unobtrusive again as it usually is: His intestines heal, obviously.

What constitutes a healthy bowel? Once a day, at least, one should have a bowel movement. If you don’t have one every day, don’t reach for the laxative. Look instead into what you are eating. Do you eat enough vegetables? Leave out sugar, trans-fats and dairy. And don’t eat what your body tells you hurts it: Stomach pain, heartburn, bloating, cramps, diarrhea, constipation, sores in your mouth – they are not cause for embarrassment but they all are signs that something is wrong with your digestion.

SAD – the Standard American Diet – is not healthy for people’s bowels. And commercial pet food – even the so-called “natural” and “scientific” - are not healthy for your pets’.

P.S. Taking a probiotic does not make up for a lousy diet, but helps reestablishing bowel health.

Nearly one in one hundred people have gluten intolerance (gluten enteropathy, sprue, celiac sprue). In only fifty percent of them does the disease show with gastro-intestinal symptoms - the rest has non-intestinal symptoms.

Be aware that many of these symptoms can also have other causes - this list does not replace a doctor who sees you!

In my thirty years in medicine, I have never diagnosed anybody with “irritable bowel syndrome.”

Not that I didn't want to make the diagnosis. But it always seemed to be the last resort - if there wasn't a better explanation for the patient's symptoms. And there always was.

If my patients came with the label, I quietly looked for a more appropriate diagnosis, mostly some kind of food intolerance and/or infections. And if they came with any of the myriad of gastrointestinal complaints, they deserved a thorough workup.

Food allergies: Physicians differ between food allergies and food intolerance. For the patient the difference is minimal: The only action that will help is leaving out the offending food.

Allergies are mediated either through blood – then they show up in blood tests. Or they are cell-mediated, which means they can’t be detected by blood tests; skin prick test is the way to go then.

If you usually feel good (or even just better) in the morning before you eat, food problems are likely. – Floating stools point to a food culprit, too.

There are rare and dangerous diseases, therefore a doctor should eliminate serious diagnoses. But this is what you can do yourself:

• Write a food journal. Everything that goes into your mouth should go in here – including beverages, pills and chewing gum. A pattern might become clear once you regularly record everything.
• In my experience, these are the most common food offenders: dairy, soy, nuts, gluten, corn – especially HFCS (High Fructose Corn Syrup), nightshades (tomato, potato, eggplant, bell and hot peppers), citrus, seafood, lectins, food colorings, preservatives, flavor enhancers (like MSG), eggs, apples and other fruit, chocolate (though probably less common than people think – it usually are the non-cacao ingredients that cause trouble), yeast. And don’t forget: prescription medication! Recreational drugs.
• Read labels! Of course, foods without labels – like kale and carrots – are healthier anyway because only processed food is required to be labeled.
• Has anybody in your family a bowel disease? You might have the same.
• Jot down pains, headache, heartburn, stomach ache, bloating, diarrhea, constipation, blurred vision, slow urination, skin rashes, blocked nose or ears,
• Don’t eat after dinner – and don’t have dinner late. The sheer bulk in your stomach may create the discomfort; besides it prevents the cell repair that should be taking place nightly – but can’t happen when your body is busy digesting.
• Are you very thirsty – especially during and after a meal? That might be a sign of a food allergy. Don’t suppress your thirst – this is how your body gets rid of the offending food: by diluting it.
• If you suspect food allergies, leave out the whole list above plus whatever you suspect for a week. Then one by one, every few days reintroduce another food from the list. – Sometimes only repeated exposure shows the problem – that happens mostly with cell-mediated allergies.
• Blood-mediated allergies are the quick ones – that can bring you to the emergency room - like peanuts. Never try to force your body into accepting any food that it doesn’t want!
• Slow allergies make you sick over time – by the chronic inflammation in your body. That causes for instance cancer in the long run.
• Take a probiotics regularly. I personally like Primal Defense (this is not an endorsement – only an idea to start with. Begin with a small dose, slowly take more. If a probiotic does not agree with you, change the brand.
• Most people benefit from fish oil – to counteract the constant inflammation that comes with food allergies.
• Chew well.
• Eat vegetables, vegetables, vegetables. Not only are they good for you – they also seem to cause fewer allergies.
• Serious runners suffer from a curious disease called “runner’s diarrhea” (about fifty percent of them.
• Obesity might be a sign for food allergies: We tend to crave exactly the foods that are worst for us.
• And most importantly: Don’t eat it if it hurts you!

Unfortunately, you can even have a bowel disease without any gastrointestinal complaints: About fifty percent of gluten intolerance (celiac sprue) patients never notice anything wrong with their belly. But they might have joint or back pain, diabetes, autoimmune disease, mental fog, depression – and a host of other problems.

Reflux is one of those ailments which keep people going to the doctor and take medication forever – and on the face of it, there’s no cure.

And, in the long run, it can be a dangerous disease. Longstanding erosion of the esophagus can lead to Barrett’s esophagus and even cancer.

Why are so many people with the diagnosis of reflux?

Reflux is, in most parts, another disease with owe to SAD – the Standard American Diet. People have intolerances to certain foods and allergies, and those keep the esophagus (and possibly the stomach and the whole gut) inflamed. Instead of eliminating the offending foods, the doctor prescribes Zantac or Tagamet or even one of the stronger proton inhibitors. And has gained a life-long patient.

In the long run, those stomach medications create new problems: Since they all reduce acidity, they also may hinder digestion, and further infections as the stomach acid is supposed to kill invading germs.

Heartburn only comes in very rare cases from producing too much acidity for no good reason (that condition is called Zollinger-Ellison syndrome, and should be ruled out by your doctor if the burning goes on relentlessly, regardless what you do). Normally, your stomach reacts with acidity when you eat something wrong. Or if you just each too much, period. So, why fighting the acidity, if you can eliminate the underlying cause?

Sometimes physicians diagnose a “hiatal hernia” – a gap in the diaphragm that allows the stomach to come a bit into the chest area. No connection has been found between HH and reflux. It seems that many people have a hiatal hernia, for reasons unknown – or for carrying a paunch that pushes the organs up into the lung cavity; for instance, it is very well known, that heartburn is extremely common in highly pregnant women. Perhaps also lacking exercise makes the diaphragm go limp. Whatever it is, hiatal hernia does not cause reflux.

If you want to break that cycle – here is what you can do:

Find out what your body does not tolerate. It is not difficult. Write a food journal. The most common culprits are, in my experience,
• Gluten
• Dairy products
• Corn syrup (HFCS)
• Tomatoes (and the whole nightshade family actually – peppers, eggplants, potatoes, too).
• Chocolate could be the culprit.
• Or nuts.
• Harsh foods: alcohol, caffeine, citrus, and spicy foods.
• ANYTHING can lead to a reaction. And not only burning in your esophagus; bloating, cramps, diarrhea, constipation, joint pains, migraine headaches, and many more symptoms can stem from food intolerance.
• Certain medical drugs are the culprits – Fosomax, for instance, that is intended to make your bones stronger (I would not touch it because of its side-effects. Better food and more movement certainly gives you stronger bones without side-effects).
• Sometimes it is not the kind of food but how it is prepared: raw versus cooked. Usually, cooked is easier on the stomach.
• It might be the timing: Some people get away with a raw salad or an acidic fruit during the day, but not at night, as the last meal that lingers in their stomach.
• Or a whole food group: Many people do better without sugars and white starches and reduced whole grains.
• Basically, all junk foods and processed foods are under suspicion. They contain trans-fats and preservatives, coloring, stabilizers, flavorings that are alien to you body.
• Drink enough water - but not with meals or right afterward.

Of course, it is better, to not be indiscreet in the first place. But if you are looking for healing alternatives:
• Mastic gum is my favorite; it is an agent that covers the stomach and helps if you have been indiscreet, food-wise. Unfortunately, mastic is not cheap. An alternative, paid by insurance is Carafate, with a similar action.
• DGL licorice helps – it is a deglycyrrhized licorice that does not have the bumping effect on blood pressure. This comes also as a lozenge.
• Other herbs that soothe the stomach are chamomile tea, aloe vera juice (or eat directly from the plant – the jelly-like inside of the leaf; avoid the green outside leaf – it is a harsh laxative), slippery elm, plantain banana, calendula and marshmallow (the real herb – not the sweet candy!), cabbage juice, artichoke extract. But watch it: I, for instance, have a chamomile allergy; that would make the situation worse.
• It is always a good idea to start out with the Ayurvedic herb neem which kills all sorts of infections because, unbeknownst, germs can cause all the indigestion. Ask your doctor.
• In an acute attack, sleep with your upper body a bit elevated (turns the flux downward).
• Always chew your food well! Big chunks might lie in your stomach like stones.
• Help your whole digestive tract with probiotics.
• Eliminate stress – especially when you eat. Sit down for three meals a day – don’t gobble things down on the run!

This is what to avoid – besides hurting foods:

• Too big meals.
• Eating after dinner.
• Peppermint – as it has a relaxing effect on the sphincter that closes of the stomach.

A reminder: Before you embark on a natural healing course, it is a good idea to have endoscopy – because you don’t want to overlook anything serious. And make sure your doctor looked for an H. pylori infection. On the other hand, there is evidence, that a bit of H.pylori might be necessary for normal digestion – and triple antibiotic definitely could do some harm.

And then – just to confuse things: Elderly people often have too low stomach acidity, and if they are taking medications that lower it even more, one can imagine that this will lead to problems. There is a supplement for this condition: betaine HCl. And some patients with can be helped with digestive enzyme – a whole new topic.

What we often call food “allergies” might be forms of intolerance with different pathways, physiologically speaking. The poisonous effect of wheat gluten in gluten enteropathy worked via a different mechanism than dairy-induced asthma; or the poison ivy dermatitis; or likely immune-complex regulated arthritis. Science has not totally elucidated these mechanisms; food “allergy” might be the incorrect term but has become common.

The diagnosis is difficult to make and to confirm; but if you don’t even think of allergy, the diagnosis can’t be made. Many physicians are not trained in this. However, you might need professional help if self-observation does not solve the problem. Since all of these conditions can also be caused by far more serious diseases, by all means work with your doctor.

Here is a list of signs that should make you wonder if you have an unrecognized food issue:

Food cravings: The more you like a food the more likely it is that you are allergic to that food. The more frequent you eat a certain food or a food group the more likely is that you will develop an allergy to it.

Fatigue: After a meal you are tired. We all are tired after a heavy meal; but if you are extremely tired even after a smaller meal you should search for an allergy.

Abdominal discomfort after a meal - often within minutes but unfortunately it can even take a day or two - you feel bloated and distressed in your stomach. Diarrhea is already a more severe sign and, if chronic or intermittently recurrent, should be evaluated by a physician. Heartburn seldom is recognized as stemming from food allergies – but it often goes away when you stop eating nightshades (tomato, bell and hot peppers, eggplant, potato), nuts or dairy.

Weakness: About fifteen minutes after a meal lift your arms: If they feel heavy or ache more than usual - compared how light you felt in the morning - this might be a case of allergy.

Mouth: Burning in your mouth, tickling in your throat or sores in your buccal mucosa or on your tongue might signal an allergy.

Bladder: Slow flow of urine can be a sign of food allergy, due to a swelling of the urethra. Or burning of the urethra in males. Or recurrent signs of urinary tract infections – with or without bacteria growing out in culture. Irritable bladder (interstitial cystitis) might respond to leaving out coffee and certain foods.

Thirst! If you are thirstier than other people – always running around with a water bottle in your hand – think allergy.

Most common food "allergies" I have encountered in patients: dairy, nightshade (tomato, potato, eggplant, all peppers except black pepper, chili, cayenne, paprika), nuts, wheat, corn, beef, food dyes and food preservatives. But basically every food can become a culprit. If you have pinpointed one food item as allergenic for you, compare it with other items in the same botanical family (like nightshade).